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Individual

ERIC O'BANION

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3506 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 864-6700
(765) 864-6703
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01046954
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200127750
IN
01
P01270966
RR MEDICARE
IN
Enumeration date
09/15/2005
Last updated
11/27/2023
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